Provider Demographics
NPI:1730708942
Name:CARMEN ELIZABETH SPOONER
Entity type:Organization
Organization Name:CARMEN ELIZABETH SPOONER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICIAN
Authorized Official - Prefix:MS
Authorized Official - First Name:CARMEN
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:SPOONER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-BACS
Authorized Official - Phone:225-627-3470
Mailing Address - Street 1:735 STONEY CREEK AVE
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70808-8191
Mailing Address - Country:US
Mailing Address - Phone:225-627-3470
Mailing Address - Fax:225-240-1089
Practice Address - Street 1:637 SAINT FERDINAND ST
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70802-6152
Practice Address - Country:US
Practice Address - Phone:225-627-3470
Practice Address - Fax:225-240-1089
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-09
Last Update Date:2020-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty